Associations between job demands, job resources and patient-related burnout among physicians: results from a multicentre observational study

BMJ Open. 2020 Sep 24;10(9):e038466. doi: 10.1136/bmjopen-2020-038466.


Objectives: To investigate associations of job demands and resources with patient-related burnout among physicians.

Design: Multicentre observational study.

Setting: Fifty medical departments at 14 (academic and non-academic) hospitals in the Netherlands.

Participants: Four hundred sixty-five physicians (71.6% response rate), comprising 385 (82.8%) medical specialists and 80 (17.2%) residents.

Main outcome measures: Job demands (workload and bureaucratic demands), job resources (participation in decision making, development opportunities, leader's inspiration, relationships with colleagues and patients)-measured with the validated Questionnaire of Experience and Evaluation of Work and Physician Worklife Survey-and patient-related burnout, measured using the validated Copenhagen Burnout Inventory.

Results: Patient-related burnout was positively associated with workload (b=0.36; 95% CI, 0.25 to 0.48; p<0.001) and negatively associated with development opportunities (b=-0.18; 95% CI, -0.27 to -0.08; p<0.001) and relationships with patients (b=-0.12; 95% CI, -0.22 to -0.03; p=0.01). Relationships with patients moderated the association between bureaucratic demands and patient-related burnout (b=-0.15; 95% CI, -0.27 to -0.04; p=0.01).

Conclusions: Physicians with high workloads and few development opportunities reported higher levels of patient-related burnout. Those with positive patient relationships were less likely to experience patient-related burnout, even in the presence of excessive bureaucracy. Therefore, positive physician-patient relationships may be supported to reduce the likelihood of physicians' patient-related burnout. However, the specific support needed to effectively reduce patient-related burnout may vary per healthcare context and thus requires intensified research across healthcare systems and settings.

Keywords: health policy; human resource management; medical education & training; quality in health care.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Burnout, Professional* / epidemiology
  • Cross-Sectional Studies
  • Humans
  • Job Satisfaction
  • Netherlands / epidemiology
  • Physicians*
  • Surveys and Questionnaires
  • Workload